Hu Junjie, Chen Yan, Dai Jie, Zhu Xinsheng, Gonzalez-Rivas Diego, Jiang Gening, Li Hua, Zhang Peng
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain.
Int J Med Robot. 2020 Oct;16(5):1-14. doi: 10.1002/rcs.2123. Epub 2020 Jun 22.
The superiority of robot-assisted thoracic surgery (RATS) over video-assisted thoracic surgery (VATS) and thoracotomy remains controversial for lung cancer.
A network meta-analysis (NMA) and pairwise meta-analysis (PMA) were performed to evaluate the perioperative outcomes using five databases.
Thirty-two studies involving 6593 patients were included for analysis. The NMA showed that RATS had similar operative time, conversion rate to thoracotomy, number of lymph node, postoperative morbidity, and length of hospital stay with VATS, except for lower 30-day mortality. Compared with thoracotomy, longer operative time and shorter hospital stay were observed in RATS, but no significant difference was observed in number of lymph node, postoperative morbidity, and 30-day mortality in both NMA and PMA. In lobectomy/segmentectomy subgroup, all outcomes, except for operative time of RATS vs VATS and number of lymph node, were similar with overall analyses.
RATS had comparable perioperative outcomes with VATS and open surgery.
对于肺癌，机器人辅助胸外科手术（RATS）相对于电视辅助胸腔镜手术（VATS）和开胸手术的优势仍存在争议。
使用五个数据库进行网络荟萃分析（NMA）和配对荟萃分析（PMA），以评估围手术期结局。
纳入32项研究，共6593例患者进行分析。NMA显示，RATS与VATS相比，手术时间、开胸手术转化率、淋巴结数量、术后发病率和住院时间相似，但30天死亡率较低。与开胸手术相比，RATS的手术时间更长，住院时间更短，但在NMA和PMA中，淋巴结数量、术后发病率和30天死亡率均无显著差异。在肺叶切除/肺段切除亚组中，除RATS与VATS的手术时间和淋巴结数量外，所有结局与总体分析相似。
RATS的围手术期结局与VATS和开放手术相当。
